Differentiated Thyroid Cancer in Elderly Patients: Experience of the Nuclear Medicine Department at CHU Hassan II of Fez

Differentiated thyroid cancer (DTC) in elderly patients (aged ≥ 65 years) poses unique clinical challenges due to late diagnosis, tumor aggressiveness, and age-related physiological changes. This retrospective study, conducted at the Nuclear Medicine Department of CHU Hassan II of Fez from 2018 to 2023, included 60 patients aged 65 years and older. The majority of cases presented with multinodular goiters (53%) and advanced-stage disease, including lymph node metastases (12%) and distant metastases (13%). Histopathological analysis revealed that 61.66% of cases were classic papillary thyroid carcinoma, while more aggressive variants were also observed. Total thyroidectomy was performed in all patients, with lymph node dissection in 16.6% of cases. Radioactive iodine therapy was administered in 91.6% of patients, with varying doses based on disease extent. Complete remission was achieved in 55% of cases, but recurrence and distant metastases remained significant challenges. Multidisciplinary management and early detection strategies are crucial to improve outcomes in this vulnerable population.